Central nervous system involvement in T-cell lymphoma: A single center experience Journal Article
| Authors: | Gurion, R.; Mehta, N.; Migliacci, J. C.; Zelenetz, A.; Moskowitz, A.; Lunning, M.; Moskowitz, C.; Hamlin, P.; Horwitz, S. |
| Article Title: | Central nervous system involvement in T-cell lymphoma: A single center experience |
| Abstract: | Background We characterized the incidence of central nervous system (CNS) involvement, risk factors and outcome in a large single institution dataset of peripheral T-cell lymphoma (PTCL).Methods Retrospective review of the PTCL database at Memorial Sloan Kettering Cancer Center. We identified 231 patients with any subtype of PTCL between 1994-2011 with a minimum six months of follow-up or an event defined as relapse or death.Results Histologies included peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS) (31.6%), angioimmunoblastic (16.9%), anaplastic large cell lymphoma (ALCL), ALK- (12.1%), ALCL, ALK+(6.1%), extranodal NK/T-cell lymphoma (7.4%), adult T-cell leukemia/lymphoma (ATLL) (7.4%), and transformed mycosis fungoides (8.7%). Seventeen patients had CNS disease (7%). Fifteen had CNS involvement with PTCL and two had diffuse large B-cell lymphoma and glioblastoma. Median time to CNS involvement was 3.44 months (0.16-103.1). CNS prophylaxis was given to 24 patients (primarily intrathecal methotrexate). Rates of CNS involvement were not different in patients who received prophylaxis. Univariate analysis identified stage III-IV, bone marrow involvement, >1 extranodal site and ATLL as risk factors for CNS disease. On multivariate analysis, >1 extranodal site and international prognostic index (IPI)3 were predictive for CNS involvement. The median survival of patients with CNS involvement was 2.63 months (0.10-75).Conclusions Despite high relapse rates, PTCL, except ATLL, carries a low risk of CNS involvement. Prognosis with CNS involvement is poor and risk factors include:>1 extra nodal site and IPI3. |
| Keywords: | chemotherapy; rituximab; classification; relapse; recurrence; prophylaxis; therapy; risk-factors; non-hodgkin-lymphoma; elderly-patients |
| Journal Title: | Acta Oncologica |
| Volume: | 55 |
| Issue: | 5 |
| ISSN: | 0284-186X |
| Publisher: | Informa Healthcare |
| Date Published: | 2016-01-01 |
| Start Page: | 561 |
| End Page: | 566 |
| Language: | English |
| ACCESSION: | WOS:000375566700005 |
| DOI: | 10.3109/0284186x.2015.1118656 |
| PROVIDER: | wos |
| PUBMED: | 27046135 |
| PMCID: | PMC5376067 |
| Notes: | Article -- Source: Wos |
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